Alcoholism and Other Addictions

Alcoholism is a disease in which a person craves alcohol, is unable to limit his or her drinking, needs to drink greater amounts to get the same effect, and has withdrawal symptoms after stopping alcohol use. Alcoholism affects physical and mental health, and causes problems with family, friends and work. It is a pattern of compulsive use of alcohol in which individuals devote substantial periods of time to obtaining and consuming alcoholic beverages despite adverse psychological or physical consequences, eg, depression, blackouts, liver disease, or other consequences.

Chronic dependence on the use of alcohol which leads to interference with health and to social and economic problems. Withdrawal of alcohol from a person with alcoholism leads to psychological and physical symptoms. A treatable, progressive condition or illness characterized by excessive consumption of alcohol to the extent that the individual's physical and mental health, personal relationships, social conduct, or job performances are impaired.

While the ingestion of alcohol is, by definition, necessary to develop alcoholism, the use of alcohol does not predict the development of alcoholism. The quantity, frequency and regularity of alcohol consumption required to develop alcoholism varies greatly from person to person.

Multiple tools are available to those wishing to conduct screening for alcoholism. Identification of alcoholism may be difficult because there is no detectable physiologic difference between a person who drinks frequently and a person with the condition. Identification involves an objective assessment regarding the damage that imbibing alcohol does to the drinker's life compared to the subjective benefits the drinker perceives from consuming alcohol.

Most people with alcoholism or those who abuse alcohol enter treatment reluctantly because they deny that they have a problem. Health problems or legal difficulties may prompt treatment. If you aren't dependent on alcohol but are experiencing the adverse effects of drinking, the goal of treatment is to reduce alcohol-related problems — often through counseling or a brief intervention, which usually involves alcohol-abuse specialists who can establish a specific treatment plan. Interventions may include goal setting, behavioral modification techniques, use of self-help manuals, counseling and follow-up care at a treatment center. Another option may be aversion therapy, in which drinking alcohol is paired with a strong aversive response — such as nausea or vomiting induced by a medication. After repeated pairing, the alcohol itself causes the aversive response, which decreases the likelihood of relapse.

Depression is a common cause of alcoholism as the depressed person seeks a way out of their problems or a relief from insomnia. Unfortunately, alcohol is itself a depressant, so the problem is only compounded. Anxiety can be temporarily relieved by alcohol, but this may lead to repeated intake and dependence. Several levels of care are available to treat alcoholism. Medically managed hospital-based detoxification and rehabilitation programs are used for more severe cases of dependence that occur with medical and psychiatric complications. Medically monitored detoxification and rehabilitation programs are used for people who are dependent on alcohol and who do not require more closely supervised medical care. The purpose of detoxification is to safely withdraw the alcoholic from alcohol and to help him or her enter a treatment program.

The urge to drink again during withdrawal can be very strong. Some people may put themselves into dangerous situations. After withdrawal symptoms go away, it's important for the person to join a treatment or sobriety program.